HIV vs. AIDS — What's the Difference?

Reviewed by Ruthann Cunningham, MD, June 26, 2017

We often think of HIV/AIDS as one and the same. But while HIV & AIDS are not the same. AIDS (Acquired Immune Deficiency Syndrome) is a condition that can develop once a person gets infected with HIV (Human Immunodeficiency Virus). To clarify, HIV is a virus that can lead to the medical condition, AIDS. With HIV treatment, the development of AIDS can be prevented. HIV can be deadly because it weakens the immune system , leaving a person open to life-threatening infections.

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HIV does not always lead to AIDS

Contrary to what some people may think, not everyone with HIV will advance to AIDS. AIDS typically only develops in advanced stages of HIV infection when a person isn’t following their treatment plan or taking their medication. Without treatment, HIV will progress and develop into AIDS in the majority of cases. This is why it is important to get tested and identify HIV infection early, to stop or delay the development of AIDS.

How HIV is spread and early signs

Everyone infected with HIV is capable of passing it to a sexual partner through anal, genital, and oral sex. It is often passed through sharing needles, or from mother to child during development or childbirth . HIV damages the body by infecting and destroying certain cells (called CD4 cells) that make up a person's immune system. The initial signs of HIV infection are vague, and sometimes go unnoticed. Patients describe feeling like they have the flu and may experience symptoms such as:

  • Fever
  • Swollen lymph nodes
  • Sore throat
  • Skin rash
  • Muscle soreness
  • Fatigue

The general nature of these early signs doesn't typically alert someone that they may be infected with HIV. This highlights the importance of HIV testing for anyone who is sexually active. Getting tested is the only way to know if you have HIV.

When HIV advances to AIDS

Once the acute phase of HIV infection is over, there may be a long, symptom-free period where an infected person feels "normal" and remains unaware of their infection. However, if HIV goes untreated, it will continually damage the body's immune system. Without diagnosis and proper treatment, a person's immune system will weaken to the point that AIDS develops. The time frame from HIV infection to development of AIDS varies from person to person, but usually occurs over a period of years.

AIDS and opportunistic infections

By medical definition, when CD4 levels drop below a level of 200 cells per milliliter of blood, AIDS has developed. It is not unusual for a person with AIDS to develop opportunistic infections or diseases that do not normally occur in people with healthy immune systems. These include Kaposi's sarcoma, lymphomas (cancers of the immune system), tuberculosis, Pneumocystis pneumonia, and several other bacterial and fungal infections . When a person with AIDS dies, it is often due to complications from these opportunistic infections.

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